Schlueter F J, Zuckerman D A, Horesh L, Gutierrez F R, Hicks M E, Brink J A
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
J Vasc Interv Radiol. 1997 Nov-Dec;8(6):1015-24. doi: 10.1016/s1051-0443(97)70704-8.
To compare the diagnostic performance of digital subtraction angiography (DSA) to that of film-screen angiography (FSA) for detecting acute pulmonary embolism (PE) in a porcine model.
DSA and FSA were performed in 13 pigs before and after central venous administration of autologous emboli. Results were compared to findings at necropsy with use of ex vivo pulmonary angiography to guide pathologic sectioning. The sensitivity and predictive value of a positive case for detecting each embolus were computed for each pulmonary artery branch order and compared with use of 95% confidence intervals. Interobserver variability among three readers for individual PE detection was calculated.
Pathologic examination of the lungs revealed 100 total PEs (location by vessel order: 1st = 1, 2nd = 0, 3rd = 15, 4th = 32, > 5th = 52). On average, FSA review identified 72 (72%) emboli and DSA review, 65 (65%). There was no significant difference in sensitivity or predictive value of a positive case between DSA and FSA for detecting emboli (P > .05). There was similar agreement among readers for individual PE detection with DSA (mean, 84%) and FSA (mean, 80%).
The diagnostic performance of DSA is equivalent to that of FSA for detecting emboli in porcine PA branches. Interobserver agreement for individual PE detection is similar for both imaging techniques.
在猪模型中比较数字减影血管造影（DSA）与屏-片血管造影（FSA）检测急性肺栓塞（PE）的诊断性能。
对13头猪在经中心静脉注入自体栓子前后分别进行DSA和FSA检查。将结果与尸检结果进行比较，尸检时采用离体肺血管造影指导病理切片。计算每个肺动脉分支级别检测每个栓子的阳性病例的敏感性和预测值，并使用95%置信区间进行比较。计算三位阅片者在个体PE检测方面的观察者间变异性。
肺部病理检查共发现100个PE（按血管级别定位：第1级 = 1个，第2级 = 0个，第3级 = 15个，第4级 = 32个，>第5级 = 52个）。平均而言，FSA阅片发现72个（72%）栓子，DSA阅片发现65个（65%）。DSA和FSA在检测栓子的阳性病例的敏感性或预测值方面无显著差异（P > 0.05）。阅片者在个体PE检测方面，DSA（平均84%）和FSA（平均80%）的一致性相似。
在检测猪肺动脉分支中的栓子时，DSA的诊断性能与FSA相当。两种成像技术在个体PE检测方面的观察者间一致性相似。
